| Prognostic value of lactic acid and 48-hour lactate clearance rate in patients with sepsis |
| Received:June 10, 2022 Revised:November 18, 2022 Click here to download the full text |
| Citation of this paper:LU Su,SUN Jian,TONG Chao-yang.Prognostic value of lactic acid and 48-hour lactate clearance rate in patients with sepsis[J].Chinese Journal of Clinical Medicine,2023,30(1):91-96 |
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| Author Name | Affiliation | E-mail | | LU Su | Department of Emergency, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | SUN Jian | Department of Emergency, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | TONG Chao-yang | Department of Emergency, Zhongshan Hospital, Fudan University, Shanghai 200032, China | tong.chaoyang@zs-hospital.sh.cn |
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| Abstract:Objective To explore the prognostic value of lactic acid and 48-hour lactate clearance rate in patients with sepsis and to establish a predictive model. Methods From June 2015 to December 2017, 202 patients with sepsis in the emergency intensive care unit of Zhongshan Hospital, Fudan University were collected. The patients were divided into survival group (n=142) and death group (n=60) according to 90-day survival. The general data, lactic acid, 48-hour lactate clearance rate, CRP, PCT, SOFA score, APACHEⅡscore and comorbidities were compared between the two groups. The risk factors of death in patients with sepsis were analyzed by multivariate analysis, and Nomogram model of predicting the prognosis of sepsis was established. The diagnostic efficacy of the model was evaluated by ROC curve and AUC. Results Compared with the survival group, PCT, CRP, lactic acid, SOFA score, and APACHEⅡscore at admission were significantly higher in death group, while the 48-hour lactate clearance rate in the death group was significantly lower than that in the survival group (all P＜0.001). Multivariate logistic regression analysis showed that APACHEⅡ score (OR=1.091, P=0.011) and lactic acid (OR=1.589, P＜0.01) were risk factors for 90-day death in patients with sepsis, and 48-hour lactate clearance rate was a protective factor (OR=0.622, P=0.021). The Nomogram model combined with 48-hour lactate clearance rate, APACHEⅡ score and lactic acid showed that the area under the ROC curve was 0.868, the sensitivity was 71.2% and the specificity was 88.1%, which was significantly better than that of other individual indicators for the evaluation of prognosis. Conclusions Lactic acid, APACHEⅡscore and 48-hour lactate clearance rate are influencing factors for 90-day death in patients with sepsis. The model constructed by above indicators can be used to predict the prognosis of patients with sepsis. |
| keywords:lactate clearance rate sepsis Nomogram prediction model prognosis |
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